NUR 645 Module 5 Milestone Two Example

Milestone Two: Program Outcomes and a Curriculum Map Marking Where Each Outcome Is Introduced, Practiced and Assessed

[Student Name]

Southern New Hampshire University

NUR 645: Curriculum Design in Nursing

Module Five Milestone Two

[Instructor Name]

[Date]

Milestone Two: Program Outcomes and a Curriculum Map Marking Where Each Outcome Is Introduced, Practiced and Assessed

A curriculum framework describes intentions. Program outcomes commit the school to abilities each graduate leaves with, and a curriculum map shows where in the program each outcome is actually taught and assessed. Without a map, faculty tend to assume that someone else covers a topic, and gaps and repetitions go unnoticed for years. Cedar Valley's composite baccalaureate program adopted a new philosophy and three framework threads in Milestone One, with clinical judgment as the first and population health as the newest. This milestone writes the program outcomes and maps them across the curriculum. It argues that outcomes written as observable end points, evidence decided before activities and a map that distinguishes introduction from assessment give faculty a tool for finding and fixing problems, not just a document for accreditors.

Writing the Program Outcomes

The eight program outcomes were written to meet three tests. Each describes an observable ability of a graduate at the end of the program, not a topic or a teaching intention. Each can be traced to one or more domains of the 2021 Essentials, which define entry-level competencies for baccalaureate graduates (American Association of Colleges of Nursing, 2021). And each connects to at least one framework thread, so that the framework shapes the outcomes rather than sitting beside them. For example, the outcome "Recognize changes in patient condition, interpret their significance and respond with timely, appropriate action and communication" draws on the Essentials domains of knowledge for nursing practice and person-centered care and on the clinical judgment thread. The outcome "Design and evaluate nursing interventions that address social and structural factors affecting the health of individuals and communities" draws on the population health domain and thread.

The remaining outcomes address safety and quality improvement, interprofessional communication, evidence-based practice, use of information technology, ethical and professional accountability and personal and leadership development. Two Essentials domains, scholarship and personal, professional and leadership development, which the framework did not cover directly, are addressed through the last two outcomes.

Deciding the Evidence First

Wiggins and McTighe (2005) describe backward design in three stages: identify the desired results, determine what evidence will show those results have been achieved and only then plan the learning experiences. Faculty often work in the opposite direction, starting from favorite content and activities. For each program outcome, the Cedar Valley faculty first agreed on the summative evidence a graduate must produce. For the clinical judgment outcome, that evidence is an entrustment level of performing with supervision available on recognizing and escalating deterioration, plus a passing score on the summative simulation in the final semester. Only after the evidence was agreed did faculty ask which courses would build toward it and where earlier, formative evidence would show that students were on track.

The Curriculum Map

Harden (2001) describes curriculum mapping as a way to make the curriculum transparent by laying out, side by side, the outcomes, the content that serves them, the learning opportunities offered and the assessments used, and argues that a map helps faculty and students see how the parts connect and where problems lie. The Cedar Valley map uses three markers. I means the outcome is formally introduced with teaching and formative practice; R means it is developed at a higher level with further practice and feedback; A means students produce summative evidence toward the outcome in that course. Each course coordinator completed the map for their course, and a curriculum committee member checked each entry against the syllabus and assignments, since coordinators tend to overstate coverage.

Table 1. Excerpt From the Revised Curriculum Map (I = introduced, R = reinforced, A = assessed summatively)

Note. The full map covers all eight outcomes and fourteen courses; this excerpt shows five outcomes across five core courses after revision.

What the Map Revealed

The first version of the map, completed against the existing curriculum, exposed three problems. Information technology was marked as introduced in four courses and assessed in none; students used the electronic health record in every clinical course, but no assignment ever evaluated their use of it. Population health was introduced, reinforced and assessed in a single semester-five community course and appeared nowhere else, which matched students' complaint that the course felt disconnected. And the content review from the needs assessment was confirmed: diabetes management was taught at the introductory level in five courses, consuming time without advancing students' understanding.

Each problem produced a change. An informatics assessment was added to Adult Health II, in which students evaluate a clinical decision support alert and its effect on care. Population health was introduced in Adult Health I through discharge planning cases that address social needs and reinforced in Adult Health II and the capstone. Diabetes content was consolidated into a planned progression, basic concepts in Foundations, complex management in Adult Health I and community-level prevention in the community course, which freed about nine hours of class time.

Keeping the Map Alive

A map completed once becomes outdated as soon as a course changes. Cedar Valley will store the map as a shared spreadsheet owned by the curriculum committee. Any course change that affects outcomes must include an updated map entry before approval. Every two years, the committee will repeat the verification against syllabi and assignments and will compare the map with assessment results: if students consistently perform poorly on an outcome at the point where it is assessed, the map shows where earlier introduction and reinforcement should be examined.

Students were also asked to review the draft map. A group of eight fourth-semester students compared it with their own experience and pointed out that safety and quality, marked as reinforced in the community course, had not been discussed there at all in their cohort. The entry was removed, and the committee added student review to the biennial verification.

Conclusion

Eight observable program outcomes, traced to the 2021 Essentials and the organizing framework, turn the curriculum's intentions into commitments. Deciding the evidence first and mapping each outcome with distinct markers for introduction, reinforcement and summative assessment made visible what faculty had not seen: an outcome never assessed, a thread confined to one course and repeated content. The changes that followed, and the rules for keeping the map current, make it a working tool for the revision.

References

American Association of Colleges of Nursing. (2021). The essentials: Core competencies for professional nursing education. https://www.aacnnursing.org/essentials

Harden, R. M. (2001). AMEE Guide No. 21: Curriculum mapping: A tool for transparent and authentic teaching and learning. Medical Teacher, 23(2), 123-137. https://doi.org/10.1080/01421590120036547

Wiggins, G., & McTighe, J. (2005). Understanding by design (Expanded 2nd ed.). Association for Supervision and Curriculum Development.